HomeMy WebLinkAbout30515-ZFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30515 Z
Permission is hereby granted to:
KAREN C BROWN
22 SOUTH WASHINGTON ST
PORT WASHINGTON, NY 11050
for :
Date JULY
27, 2004
ADDITION TO AIq EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR
at premises located at 1300
County Tax Map No. 473889 Section 064
pursuant to application dated JUNE
Building Inspector to expire on JAN/IARY
FOUNDERS PATH SOUTHOLD
Block 0004 Lot No. 006
7, 2004 and approved by the
27, 2006.
Fee $ 150.00
Authorized Signature
ORIGINAL
Rev. 5/8/02
LELD INSPECTION REPORT I DATE ] COMMENTS '
FOUNDATION (1ST) _
FOUNDATION (2ND) · ~L-.~.~
PLYING
INSULATION PER N. Y.
STATE ENERGY CODE
ADDmONAL COMMENTS
L
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
PERMIT NO.
Examined Z;/~ ,20 ~r
Approved ~'/2.7 ,20 a~/
Disapproved a/c
Expiration
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans.
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Phone:
Building Inspector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS /
,2o, 4-
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Pemait.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
· e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
~ f. Every building permit shall expire if the work authorized has not cormnenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing cod~'~d regulations, and to admit
authorized inspectors on premises and in building for necessary inspections. ~ ~
J J (Signatureofapplicant ornsme, ifa corporation)
(Mailing address of applicant) t/(q,,~/
State whether applicant is owner, lesse~ agent, architect, engin/eer, general contractor, electrician,
Name of owner of premises /Q~ ~'r_-o' ~--~. ~~.
(As on the tax roll or latest deed)
If applicant is a corporation, signatur~9)~u, ly authorized officer
(Name and title of corporate officer) "
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
plumber or builder
1. Location of land on which proposed work g~)ll be done:
House Number Street Hamlet
County Tax Map No. 1000 Section ~ ~ Block ~ 4--
Subdivision ~,o~ ~>z-;~r-~ Filed Map No. ~ ~ 4-
(Name)
Lot
Lot
State existing use and occupancy of premises and intended use and occupancy or, posed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost
Fee
Addition
Other Work
If dwelling, number of dwelling units
If garage, number of cars
Alteration ~>~
Number of dwelling units on each floor
(Description)
(To be paid on filing this application)
/
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions ofexis__ting structures, if any: Front
Height Number of Stories I
Dimensions of same structure with alterations or additions: Front
Depth
Rear fi-4. ?-
Depth .5--'~:~ Height ~-- Number of Stories /'
Dimensions of entire new construction: Front
Height Number of Stories
Size of lot: Front 7o~'9--~ Rear ~ 5
10. Date of Purchase/~,o ~ za~ ~ Name of Former Owner 6)~ h:;~6w~e~
11. Zone or use district in which premises are situated ~ -~
12. Does proposed construction violate any zoning law, ordinance or regulation? YES
13. Will lot be re-graded? YES__
Rear .Depth.
Depth ~ ~' ~"'.
/
NO J
NO ~Will excess fill be removed from premises? YES ~NO __
14. Names of Owner of premises..~ : --"-~ (--~------~'~ _
Name of Architect .~ 7"-,,~,~ ,-,-,' .~
Name of Contractor tOa'C ~-~F--w'
Address~. ~'~$~/~fr,~ //~7~Phone No.
Address :~5',~/~F-~e~ Phone No
Address Phone No.
15 a. Is this property within 100 feet ora tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES__ NO__
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO J
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OFS'a/,cr-~/c_ .)
~. ~4.4.~ ~-~(7-'-~f ' ~7~/L4,~ 5'. being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the ~.e~-~q--~..~ ~:~o F
(Contractor, Agent, Corporate Office~, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me thig~'~
~ ~day of ~,/~'~-- 200cf
/~P l~otary Public
JOYCE M. WILKINS
Notary Public, State of New York
No. 4952246, Suffolk County
Term Expires June 12, ~00 ~
/' / - Signa"ture gfApplicant
PKOPERTY RECORD CARD
OWNER VI LLAGE
OWNER N
S
DISTRICT SUB.
W
'~ES.
SEAS.
VL.
~,/~
LAND IMP. TOTAL DATE
70-0
AGE
NEW
Farm
Tillable 1
Fillable 2
Tillable, 3
Woodland
Swampland
NORMAL
¥
BUILDING CONDITION
BELOW
Ac re
ABOVE
FRONTAGE ON WATER
Value Per Acre
Brushland
House Plot
Total
Value
FRONTAGE ON ROAD
BULKHEAD
DOCK
64-4-6 9/00
vL Bldg.
Basement I/,/'g~ Floors
[xtension
'~'~ ~ ~xt. Walls ~/~ Jnterior Finish
~ension '~ Fire Pl~ce ~ ~ He~t
Pomh R~f T~e
, Porch Roo~ 1st Flor
~reezeway ~ Patio Rooms 2nd Flor
~arage ~:~ Driveway Dormer
Robert I. Scott Jr., Chairman
Scott A. Russell, Assessor
Darline J. Duffy, Assessor
Southold Town Hall, 53095 Route 25
P.O. Box 1179
Southold, NY 11971-0959
Fax: (631) 765-1356
Telephone: (631) 765-1937
BOARD OF ASSESSORS
TOWN OF SOUTHOLD
MEMORANDUM
To~
From:
Re:
Date:
Building Depj~:l~ent
Scott Russell ~J
SCIM# 1000-64-4-6
1000-64-4-3
Owner: Brown, Karen
July 26, 2004
Please be advised that the above referenced properties have been combined. The
new parcel ID number is 1000-64-4-6.1
The prior numbers referenced above have been retired and no longer apply to the
property. The merger was completed on July 6, 2004 and does not yet appear on
the assessment roll.
If you have any questions, do not hesitate to contact me.
SAR:mj
Town Hall. 53095 Main Road
P.O. Box 1179
Southold. New York 11971~0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Fax 1631 ) 765-9502
Telephone (631 ) 765-1802
October 4th, 2006
Karen C. Brown
22 South Washington Street
Port Washington, N.Y. 11050
RE: 1300 Founders Path
SCTM# 064 0004 006
Dear Ms. Brown,
Please be advised that your Building Permit #30515 issued July 27th 2004 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of $150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDiNG DEPT.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York 11971-0959
Fax (631 ) 765-9502
Telephone (631 ) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
March 27th, 2007
Karen C. Brown
22 South Washington Street
Port Washington, N.Y. 11050
2ND NOTICE
RE: 1300 Founders Path (addition)
SCTM: 64 4 6 · I
Dear Ms. Brown,
Please be advised that your Building Permit #30515 issued July 27th, 2004 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit, please submit a fee of $150.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
Town Hall Annex
.5 [37.5 Main Road
P.O. 1½ox 1179
Soulhold, Nh' 11971-0939
Tckphonc (631) 765-1802
Fax (631) 76.5-9.50'2
1½l ;ILl)IN(; 1)EPARTMENT
TOWN OF SOUTHOLD
fiAarch 16*h, 2010
Koren C. Brown
22 5. Washington Street
Port Washington, N.Y. 11050
Re: 1300 Founders Path / Violation
SCTM# 1000-64.-4-6.1
To Whom This May Concern:
Your BUILDIIq6 PERM:D- # 30515 for construction of an ADDITION has been referred
to me because you hove not ~esponded to requests to obtain your Certificate of
Occupancy as required by Southold Town code.
Pursuant to 144-15A, of the 5outhold Town Code, "No building hereafter erected
shall be used or occupied in whole or in part until o certificate of occupancy shall
hove been issued by the Building Inspector."
Therefore, you hove ten days from the receipt of this letter to submit a check mode
out to the Town of ~outhold in the amount of $200.00: to renew the building permit,
or legal action will be taken against you. Should you hove any questions, coil the
building deportment between the hours of 8:00 a.m. and 4:00 p.m.
Respectfully Yours,
Damon Rallis, Zoning Inspector
$outhold Building Depo~tment